Gauging 5-year outcomes after concussive blast traumatic brain injury

May 01, 2017

Most wartime traumatic brain injuries (TBIs) are mild but the long-term clinical effects of these injuries have not been well described. A new article published by JAMA Neurology identifies potential predictors of poor outcomes in service members diagnosed with concussive blast TBI.

The study by Christine L. Mac Donald, Ph.D., of the University of Washington School of Medicine, Seattle, and coauthors included 50 active-duty U.S. military service members with concussive blast TBI and 44 service members who were combat-deployed but had no TBI. They were enrolled from November 2008 until July 2013 either in Afghanistan or after evacuation to a medical center in Germany. Clinical evaluations in the United States were done after one and five years.

Overall, 36 of the 50 patients with concussive blast TBI (72 percent) had a decline in an overall measure of disability from the one- to five-year evaluations, according to the results.

Satisfaction with life, global disability, neurobehavioral symptom severity, psychiatric symptom severity and sleep impairment were worse in patients with concussive blast TBI compared with the combat-deployed service members without TBI, although performance on cognitive measures was no different between the two groups at the evaluation after five years, according to the article.

Risk factors for poor outcomes after five years appear to be brain injury diagnosis, preinjury intelligence, motor strength, verbal fluency and neurobehavioral symptom severity at one year, the authors report.

In addition, between the one- and five-year evaluations, 18 combat-deployed service members without TBI (41 percent) and 40 patients with concussive blast TBI (80 percent) reported seeking help from a licensed mental health professional but only nine combat-deployed service members without TBI (20 percent) and nine patients with concussive blast TBI (18 percent) reported that mental health programs helped, according to the results.

The study notes some limitations, including its modest sample size.

"Together these findings indicate progression of symptom severity beyond one year after injury. Many service members with concussive blast TBI experience evolution rather than resolution of symptoms from the one- to five-year outcomes. Even a small percentage of combat-deployed controls appeared to experience worsening over time. In both groups, this finding appears to be driven more by psychiatric symptoms than by cognitive deficits. ... We believe that by being informed from longitudinal studies such as this one, the medical community can be proactive in combatting the potentially negative and extremely costly effect of these wartime injuries," the article concludes.
-end-
For more details and to read the full study, please visit the For The Media website.

(JAMA Neurol. Published online May 1, 2017. doi:10.1001/jamaneurol.2017.0143; available pre-embargo at the For The Media website.)

Editor's Note: The article contains funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

The JAMA Network Journals

Related Injuries Articles from Brightsurf:

COVID-19 frequently causes neurological injuries
Without directly invading the brain or nerves, the virus responsible for COVID-19 causes potentially damaging neurological injuries in about one in seven infected, a new study shows.

Head and neck injuries make up nearly 28% of all electric scooter accident injuries
A Henry Ford study is sounding the alarm on the rise of electric scooter injuries, and particularly head and neck injuries, since the 2017 introduction of e-scooter rideshare programs in urban centers.

Reasons for football injuries
If professional footballers are out of action due to injuries, this can have serious consequences for the club.

Glass tables can cause life-threatening injuries
Faulty glass in tables can cause life-threatening injuries, according to a Rutgers study, which provides evidence that stricter federal regulations are needed to protect consumers.

Concerns over police head injuries
Head injuries may be worryingly common among police officers, according to a new pilot study led by the University of Exeter.

Firework-related eye injuries
Emergency department data were used to describe the number, type, severity and factors associated with firework-related eye injuries that occurred in the United States from 1999 to 2017.

Injuries from motorized scooters
Motorized scooters are increasingly popular and, in this study, researchers analyzed medical information for 61 adults who visited a single emergency department with scooter-related injuries.

Children's fingertip injuries could signal abuse
Many children who suffer fingertip injuries have been abused, according to a Rutgers study.

Cell phone injuries
Cell phones are mainstays of daily life. This observational study analyzed 20 years of data on people who went to emergency departments with head and neck injuries from cell phone use to estimate the number of injuries, learn what types of injuries there were, and understand how the injuries occurred, such as from distracted driving or walking.

New study looks at motorized scooter injuries
More than half of people who received X-rays or CT scans after electric scooter accidents were found to have injuries, most commonly to the upper extremities, according to a new study.

Read More: Injuries News and Injuries Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.